Self-efficacy, coping strategies and quality of life in women and men requiring assisted reproductive technology treatments for anatomical or non-anatomical infertility.

OBJECTIVE: To examine the magnitude and the predictors of emotional reactions to an infertility diagnosis, comparing women and men who were clinically diagnosed with an anatomical cause of infertility or non-anatomical cause of infertility. STUDY DESIGN: Cross-sectional study involving a total of 133 adults waiting for infertility treatment at the IVF and Infertility Unit of the S. Orsola University Hospital in Bologna (Italy). Of these, 107 patients (55 with anatomical causes of infertility and 52 with non-anatomical causes of infertility; response rate: 80%) took part to the study. After providing informed written consent, each participant was asked to complete the Infertility Self-efficacy Scale, the Fertility Quality of Life, and the Brief Coping Orientation to Problem Experienced, which they returned at their second access to the Unit. Differences between the groups were analyzed through a series of univariate ANOVA, whereas a multiple regression analysis was used to jointly examine the predictors of fertility quality of life. RESULTS: Results showed both gender related and diagnosis related differences. Women had statistically significant lower scores than men on the Infertility Self-Efficacy Scale and on the global, emotional, and mind-body subscales of the Fertility Quality of Life, while they scored significantly higher on the emotion focused and socially supported subscales of the Coping Orientation to Problem Experienced. Independently of gender, patients with non-anatomical causes of infertility scored poorly than patients with anatomical causes of infertility on the relational subscale of the Fertility Quality of Life and on the Avoidant scale of the Brief Coping Orientation to Problem Experienced. Hierarchical multiple regression analyses revealed that higher levels of self-efficacy and a lower use of avoidant coping strategies predicted a more positive quality of life over and above gender and cause of infertility. CONCLUSION: This study partly confirms data on gender differences in experiencing the psychological burden of infertility and adds some new information, particularly with respect to the prediction of quality of life indicators over and above infertility cause.

Continuity of phenomenology and (in)consistency of content of meaningful autobiographical memories.

Phenomenology is a critical component of autobiographical memory retrieval; it reflects both (a) memory-specific features and (b) stable individual differences. Few studies have tested phenomenology longitudinally. The present work examined the continuity of memory phenomenology in a sample of Italians adults (N=105) over a 4-week period. Participants retrieved two 'key' personal memories, a Turning Point and an Early Childhood Memory, rated the phenomenology of each memory, and completed measures of personality, psychological distress and subjective well-being. Phenomenological ratings were moderately stable over time (median correlation >.40), regardless of memory content. Personality traits, psychological distress and well-being were associated with phenomenology cross-sectionally and with changes in phenomenology over time. These results suggest that how individuals re-experience their most important personal memories is relatively consistent over time and shaped by both trait and state aspects of psychological functioning.

Impact of Michelangelo prosthetic hand: Findings from a crossover longitudinal study.

This work explores the functional and psychosocial impact of the multigrip Michelangelo (M) prosthetic hand. Transradial myoelectric prosthesis users (6 men, median age: 47 y) participated in a crossover longitudinal study. A multifactorial assessment protocol was applied before the application of M and after 3 mo (functional assessment) and 6 mo (psychosocial assessment) of home use. Functional assessment included both practical tests (i.e., Southampton Hand Assessment Procedure [SHAP], Box and Blocks Test [BBT], and Minnesota Manual Dexterity Test [MMDT]) and self-report functional scales. Psychosocial assessment consisted of a clinical interview and a battery of self-report questionnaires concerning current anxious-depressive symptoms and health-related quality of life, body image concerns, adjustment and satisfaction with prosthesis, social support, coping style, and personality. Increased manual dexterity was observed after 3 mo based on improvements in the SHAP, BBT, and MMDT. Two important themes emerged from the clinical interviews at the 6 mo follow-up: (1) the enhanced functionality and (2) the "like a real hand" aspect of the M, which further increased prosthesis integration to the Self. A few patients expressed concerns about M dimension, noise, and weight. The M appeared to restore hand function and natural appearance. The present findings provide preliminary evidence, and additional studies are needed.

Autobiographical memory and psychological distress in a sample of upper-limb amputees.

Amputation is a traumatic and life-changing event that can take years to adjust to. The present study (a) examines psychological adjustment in a specific trauma-exposed sample, (b) compares the phenomenology (e.g., vividness) of amputation-related memories to more recent memories, and (c) tests whether memory phenomenology is associated with psychological distress. A total of 24 upper-limb amputees recalled two autobiographical memories--an amputation-related memory and a recent memory--and rated the phenomenological qualities of each memory, including Vividness, Coherence, Emotional Intensity, Visual Perspective, and Distancing. Participants also completed self-rated measures of psychological distress and personality. The sample was generally well adjusted; participants showed no relevant symptoms of anxiety and depression, and personality scores were similar to the general population. There were no significant differences in phenomenology between the two types of memories recalled. Even though amputation-related memories were, on average, almost 20 years older than the recent memories, they retained their intense phenomenology. Despite the intensity of the memory, none of the phenomenological dimensions were associated with psychological distress. It is worth to further define which dimensions of phenomenology characterize memories of traumatic events, and their association with individuals' psychological reactions.

An entire life in one glance: a psychoanalytic reading of Revolutionary Road.

This article, starting from an analysis of the film Revolutionary Road (2009; director, Sam Mendes), addresses the topic of conflictuality in relationships between couples, especially in those characterized by intense violence and a relational configuration of the sadomasochistic type. In particular, the film - in highlighting sequential moments in the couple's life, from its formation through to its tragic conclusion - seems to strengthen the hypothesis that the specific quality of falling in love is a contributing factor in determining the dramatic unfolding of a couple's relationship. The relationship is characterized by an experience of intense, erotic sensoriality, and by the nature of the unconscious fantasy underlying the bond between the couple that began with the moment of falling in love, a bond in which deep needs for fusion predominate. The presence of this neediness impedes a more adequate working through of the conflicts and the transition to more satisfying ways of relating.

Greater pressor reactivity in women with pre-eclampsia is not related to specific psychological or emotional stressors.

To investigate whether emotional or psychosocial factors could be significantly related with the development of pre-eclampsia, 15 pregnant women with early diagnosis of pre-eclampsia and 15 normotensive pregnant controls of comparable age (23-37 yr.), gestational age (10-37 wk.), parity (70% primiparous), amount of instruction, and marital status underwent a blood pressure monitoring during a specific psychological assessment based on a semistructured interview followed by the administration of three different questionnaires: the Symptom Checklist 90-Revised, the Perceived Stress Questionnaire-Recent, and the Questionnaire about Social Relationships. Systolic and diastolic blood pressure and heart rate were measured at 2-min. intervals by an automatic device both during the interview and the questionnaires' administration. Both systolic and diastolic responses were significantly increased in both groups during the interview (deltaSBP = 15 vs. 10%; deltaDBP=28 vs. 15.8%), whereas no differences were observed in blood pressure while answering questionnaires. Conversely, differences in questionnaire responses between groups were not statistically significant. Present results confirm a greater pressor reactivity in these women with pre-eclampsia but does not specifically support that this was related to psychological or emotional stress.

Adult attachment styles and psychological disease: examining the mediating role of personality traits.

The aim of the present study was to examine differences in anxiety and depression related to differences in attachment models of the self and of others and whether personality traits mediate this relationship. The authors assessed attachment styles, anxiety, depression, and personality traits among 274 adult volunteers. Participants were classified into 4 attachment groups (secure, preoccupied, fearful, and dismissing-avoidant) according to K. Bartholomew's (1990) model. The present authors found significant differences among attachment groups on anxiety and depressive symptoms with attachment styles involving a negative self-model showing higher scores than attachment styles characterized by a positive self-model. The authors also found that differences between attachment styles in anxiety and depression remained significant when personality factors related to attachment prototypes were entered as covariates. Results indicate that secure attachment in adults was associated with better mental health, while insecure attachment styles characterized by negative thinking about the self were associated with higher depression and anxiety scores. Our findings seem to evidence that attachment and personality are only partly overlapping and that attachment cannot be considered as redundant with personality in the explanation of psychological disease.

Institutional therapeutic alliance and its relationship with outcomes in a psychiatric day hospital program.

The article shows the results of a longitudinal study aimed to explore the institutional therapeutic alliance (ITA) that is the alliance formed by a patient and all the therapeutic staff. Fifty five patients who have psychiatric disorders in partial hospitalization were evaluated at admission (global functional level, social support, symptomatic condition, and treatment expectancies), at discharge, and after 3 months. ITA was assessed after 1 week of treatment and at discharge, from patient's and staff's perspectives. Preliminary findings suggest that the ITA represents a specific phenomenon different from the classical therapeutic alliance (patienttherapist), which would be particularly relevant for the treatment of patients who are severely disturbed.

Emotion recognition and expression in young obese participants: preliminary study.

This study of the presence of alexithymic characteristics in obese adolescents and preadolescents tested the hypothesis of whether they showed impaired recognition and expression of emotion. The sample included 30 obese young participants and a control group of 30 participants of normal weight for their ages. Stimuli, 42 faces representing seven emotional expressions, were shown to participants who identified the emotion expressed in the face. The Level of Emotional Awareness Scale was adapted for children to evaluate their ability to describe their emotions. Young obese participants had significantly lower scores than control participants, but no differences were found in recognition of emotion. The lack of words to describe emotions might suggest a greater prevalence of alexithymic characteristics in the obese participants, but the hypothesis of a general deficit in the processing of emotional experiences was not supported.

Anxiety and body satisfaction before and six months after mastectomy and breast reconstruction surgery.

As breast reconstruction is an important adjunct after mastectomy to regain physical integrity and also to improve affect, the present aim was to evaluate patients' subjective perceptions of body image during the whole breast reconstruction period and to assess the importance of their psychological reaction in terms of negative affectivity. Participants were 62 women, 43 women (M age = 46.4, SD = 9.8) who had had mastectomies and 19 healthy women (M age = 39.9, SD = 13.99). Patients were admitted for surgery at the Hospital S. Orsola in Bologna. Healthy subjects were relatives of the women and students, all with no history of breast pathology. The Body Satisfaction Scale and the State Anxiety Inventory-Y were administered to the two groups before, post, and 6 mo. after surgery. Analysis of scores indicated that during the period of the study, the women with mastectomies reported higher anxiety and also greater dissatisfaction with their body image than the healthy group, even when the breast had been reconstructed. This unexpected finding suggests patients' unrealistic expectations of the breast reconstruction and the surgical outcome.

Facial emotion recognition in trait anxiety.

The study investigated the relationship between recognition of emotional facial expressions and trait anxiety. A nonclinical sample of 19 participants with high-trait anxiety was selected, using the trait version of the State-Trait Anxiety Inventory, and compared with a sample of 20 participants with low-trait anxiety on a facial expression recognition task. Visual stimuli were 42 faces, representing seven emotional expressions: anger, sadness, happiness, fear, surprise, disgust and neutral. Participants had to identify the emotion portrayed by each face. Results showed that participants with high-trait anxiety recognized fear faces significantly better while the two groups did not differ in recognition of other facial expressions.

Narcissism versus proneness to shame and guilt.

The aim of this study was to evaluate the correlations between the narcissistic personality trait, measured with the Narcissistic Personality Inventory, and proneness to shame and guilt, measured with the Shame-Guilt Proneness Scale. Participants were 165 students (83 men, 82 women), aged 19-30 years. Pearson product-moment correlations, with computations comparing NPI Total score with each of the Shame-Guilt Proneness Scale subscales, were negative for scores on narcissism and shame and for those on narcissism and guilt. These data are consistent with previous findings, which suggest that the "overt" type narcissist is immune to feelings of guilt and may be characterised by a negation of the experience of shame.

Use of the Drawn Stories Technique to evaluate psychological distress in children.

This study evaluated the validity of analyzing children's drawings using the Drawn Stories Technique for psychodiagnostic assessment and clinical investigation of children. The research was conducted on a sample of 211 subjects (102 girls, 109 boys), 99 in primary school and 112 in secondary school. Three measures of psychological distress were given: the Drawn Stories Technique (considering two types of outcome of the stories as an index of psychological distress: story with a negative outcome and story with a positive outcome), and two self-report scales, the Anxiety Scale Questionnaire for Children and the Children's Depression Inventory. Analyses for both age groups indicate a prevalence of positive outcomes over negative outcomes, with a similar distribution in the two age groups. Greater anxiety and depression were found for subjects with a prevalence of negative outcome in the stories, and girls scored generally as more anxious and depressed than boys. These results indicate that the Drawn Stories Technique shows construct validity for use with children and is sensitive enough to detect their psychological distress, in terms of anxiety and depression.